Provider Demographics
NPI:1134185879
Name:ROSELLA, ROSE MARY MALLOY (MA, NCC,LPC)
Entity type:Individual
Prefix:MRS
First Name:ROSE MARY
Middle Name:MALLOY
Last Name:ROSELLA
Suffix:
Gender:F
Credentials:MA, NCC,LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:582 STERLING ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1825
Mailing Address - Country:US
Mailing Address - Phone:215-968-2637
Mailing Address - Fax:215-547-0768
Practice Address - Street 1:333 N OXFORD VALLEY RD
Practice Address - Street 2:STE 202
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2624
Practice Address - Country:US
Practice Address - Phone:215-547-5774
Practice Address - Fax:215-547-0768
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPC-002683101YP2500X
PAPS-007508L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling